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Return to Work after Mental Disorders

How to successfully return to work after a mental crisis?

Mental disorders increase the risk of unemployment and of early retirement. For this reason, it is important to support people to return to work after a mental crisis. At present, BAuA is carrying out research on RTW in several projects.

Man walking along a long windowed corridor. © Uwe Völkner, Fotoagentur FOX

In Germany, every year several hundred thousand employees stop working for a long-time or forever. This is increasingly happening is due to mental disorders. For example, the number of working days lost because of mental disorders increased throughout Germany between 2001 and 2012 from 33.6 million to 60 million.

Mental health and disorders in the world of work

Health promotion is an important resource for the mental health and workability of employees. Mental health is not just physical, mental and social well-being, but also the competence to cope with challenges, problems and crises constructively. In addition, it is not just the absence of disease, but rather a dynamic relationship between being healthy and being sick. Mental health and disorders are therefore two states that are dependent on one another.
In this sense, successful processing or coping with a mental crisis and an effective return to work is also an expression on mental health.

Central aspects of reintegration after a mental crisis

A significant challenge on reintegration following a mental crisis is the fear of stigmatization, because stigmatization, or fear of it, influences

  • self-confidence,
  • target orientation,
  • social interaction, and therefore
  • tthe workability of returning employees as well.

Along with fear and uncertainty, stigmatization also provokes labour conflicts and limits productivity. This hampers early treatment and return to work.

This is why it is important to deal openly with the subject of mental health, and to enable an appropriate communication with the company. What is helpful here is above all training sessions for managers, as well as informing and involving co-workers.

Which factors can influence reintegration?

Along with interpersonal conditions, there are a number of additional factors that can, in different ways, influence the RTW process after mental disorders:

  • the severity and above all the duration of the disease,
  • the subjective RTW prognosis,
  • the self-management of the returnees,
  • the early cooperation between the treating physicians, therapists, returnees and key company players,
  • the professional support for returning employees,
  • the social support from supervizors and colleagues,
  • the gradual reintegration as a therapeutic measure, and
  • further preventive and health-promoting measures.

Special importance is assigned to the interleaving of individual and work-related measures, in which, for example, the self-management of returning employees is supported by feedback and coaching sessions with supervisors and RTW experts (RTW coaches, employability coaches, disability managers). For designing the return to work and the implementation of the measures, a personal risks assessment and stepwise reintegration is highly important.

The therapeutic orientation of the stepwise reintegration makes it possible to achieve an optimal fit between individual, social and operational conditions: in the direct confrontation with themselves, in the team and the working conditions.

From prevention to reintegration: BAuA's research projects

One of BAuA's concerns is to link and improve measures of prevention and reintegration. Against this background, was launched the project bundle "Mental disorders in the world of work" ("Psychische Erkrankungen in der Arbeitswelt"). It comprises four sub-projects:

  • scoping reviews on RTW determinants,
  • mixed methods follow-up study on determinants of successful reintegration,
  • study of psychosomatic consultation in the workplace,
  • study on the linking of clinical and operational players in the RTW process.

For further detailed information please refer to our German Website.